Association between physical activity changes and risk of incident ischemic stroke following cancer diagnosis: A nationwide retrospective cohort study

Author:

Jung Wonyoung12,Cho In Young34,Jung Jinhyung5,Cho Mi Hee6,Koo Hye Yeon7,Park Yong‐Moon Mark89,Cho Be‐Long10,Kwon Hyuktae10,Park Jin Ho10,Han Kyungdo11,Shin Dong Wook34ORCID

Affiliation:

1. Department of Family Medicine/Obesity and Metabolic Health Center Kangdong Sacred Heart Hospital Hallym University Seoul Republic of Korea

2. Department of Medicine Sungkyunkwan University School of Medicine Seoul Republic of Korea

3. Department of Family Medicine and Supportive Care Center Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea

4. Department of Clinical Research Design and Evaluation Samsung Advanced Institute for Health Science & Technology (SAIHST) Sungkyunkwan University Seoul Republic of Korea

5. Department of Biostatistics College of Medicine Catholic University of Korea Seoul Republic of Korea

6. Samsung C&T Medical Clinic Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Republic of Korea

7. Department of Family Medicine Seoul National University Bundang Hospital Seongnam Republic of Korea

8. Department of Epidemiology Fay W. Boozman College of Public Health University of Arkansas for Medical Sciences Little Rock Arkansas USA

9. Winthrop P. Rockefeller Cancer Institute University of Arkansas for Medical Sciences Little Rock Arkansas USA

10. Department of Family Medicine Seoul National University Hospital Seoul Republic of Korea

11. Department of Statistics and Actuarial Science Soongsil University Seoul Republic of Korea

Abstract

AbstractBackgroundPhysical inactivity is prevalent after cancer treatment, which could increase ischemic stroke risk in cancer survivors. This study investigated the association between physical activity change from pre‐ to post‐diagnosis and ischemic stroke risk among cancer survivors.MethodsUsing data from the Korean National Health Insurance Service database, 269,943 cancer survivors (mean [SD] age, 56.3 [12.1] years; 45.7% male) with no history of cardiovascular disease were evaluated based on changes in physical activity from pre‐ to post‐diagnosis. Using the Fine‐Gray model, subdistribution hazard ratios (sHRs) and 95% confidence intervals (CIs) for ischemic stroke risk were calculated, considering death as a competing risk.ResultsAfter cancer diagnosis, 62.0% remained inactive, 10.1% remained active, 16.6% became active, and 11.4% became inactive. During a mean (SD) follow‐up of 4.1 (2.0) years, being active both pre‐ and post‐diagnosis was associated with a 15% decreased risk of ischemic stroke (sHR, 0.85; 95% CI, 0.75–0.96), compared with those who remained inactive. Cancer survivors who became active and inactive post‐diagnosis showed a 16% and 11% lower ischemic stroke risk (sHR, 0.84; 95% CI, 0.75–0.93; sHR, 0.89; 95% CI, 0.79–0.99), respectively, than those who remained inactive. Analysis by the primary cancer site did not substantially differ from the main findings.ConclusionsPhysical activity is associated with reduced ischemic stroke risk among cancer survivors. The potential benefits of physical activity are not limited to individuals who were physically active before cancer diagnosis, thus preventive strategies against ischemic stroke should emphasize physical activity throughout the cancer journey.

Publisher

Wiley

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